T1 Hypos for Dummies questions....

[Tezzz]

I'm Type 2 and can't get my head around hypos that T1s have so here's a stoopid (for me) question or two.

Why does the blood sugars go sky high after a hypo correction?

Say you go hypo with a reading of say 2.5. You want to aim for a BG of say 6.

Surely the maths says that if you need x grammes of carbs to raise your BG by 1 mmol then if you have enough to bring your BG up from 2.5 to say 6 then enough carbs to cover 3.5 mmol then no problem...? But however it doesn't seem to work.

Is the liver interfering with corrections?

If you went hypo would you prefer to correct in small amounts sipping Lucozade or 'go for it' with a couple of Mars bars..?

 

[Caroline]

can't answer your other points, but mars bars are chocolate and have fat in them. The fat slows down the rate of glucose absorption, so are usefull when you have done everything else and want to steady things a bit but not so great for getting the glucose into your system now.

 

[Northerner]

Hi Tez, not silly questions at all! You're right in thinking that the liver may play a part in the rebounding highs. When we are hypoing, the brain is in distress and starts alerting various glands to put out stress hormones like adrenalin, cortisol and glucagon - all these stimulate the liver to put out a glucose surge. This is what is generally thought to happen when people wake high from a night hypo in particular. During waking hours, the mechanisms may be slightly different, and something that affects people differently (as you might guess!). If I find myself at 2.5, then I'll have three jelly babies and that will normally bring me up into normal range. Occasionally it doesn't and you end up eating more and more until it starts to take effect. Some people also feel so hungry after a hypo that they overtreat without really realising, as you're not always that rational or able to resist temptation!

 

[Lizzie]

I'm not sure there is a way of precisely measuring how many carbs to eat to get your blood sugar to a certain level. All I have heard is to have around 20g carbs then wait 15 minutes to see if that has worked.

Also depending on how bad the hypo is (and this for me differs with each one, it has little to do with what the meter says) it can seem like you have not eaten enough, you still feel faint and ill even though you have eaten 20g carbs. Sometimes it seems to take longer for the body to respond. This is worst for me with a night hypo, with the faintness added to being half asleep. But even in the day, when hypo I am a bit confused and don't always remember how many jelly babies I have eaten.

Another factor is if you are out or at work and you want to try and get the hypo treated as soon as possible to get back on with what you are doing, you might eat more. Of course this is not actually possible and just causes a high later, but my logical brain doesn't work so well during a hypo!

 

[MarcLister]

Hi Tez. Yeah tell me about it. If I have a hypo at lunch of say 3.5 I'll look at the amount of insulin I was going to take for lunch, say it should be 7.8 because the carbs I'm eating divided by 11 (for every 11g of carbs I need 1 unit of Novorapid). Now before I might have had 8 units of insulin as its 7.8. So I take 7 to account for my hypo.

Then at dinner I'd be 8.7 and I don't get how taking one unit less to compensate for the hypo can cause me to go that high after. Guess its just the body messing around and complicated physiology I'll never understand.

 

[insulinaddict09]

I'm Type 2 and can't get my head around hypos that T1s have so here's a stoopid (for me) question or two.

Why does the blood sugars go sky high after a hypo correction?

Say you go hypo with a reading of say 2.5. You want to aim for a BG of say 6.

Surely the maths says that if you need x grammes of carbs to raise your BG by 1 mmol then if you have enough to bring your BG up from 2.5 to say 6 then enough carbs to cover 3.5 mmol then no problem...? But however it doesn't seem to work.

Is the liver interfering with corrections?

If you went hypo would you prefer to correct in small amounts sipping Lucozade or 'go for it' with a couple of Mars bars..?

Each hypo varies so much , ive had 1.9's and felt fine drank a small glass of lucozade and got back to normal fairly quickly without a huge rise in blood glucose. Hmm others ... well sometimes when hypo you get what I call the hypo munchies when your brain is just telling you to KEEP EATING .. arghhh you just cant stop😱 thats usually when i'll then zoooooom to the 20's and have to correct also as each hypo is different ive been ok at 1.9 but totally out of it and confussed at 3 grrrr bloody hypos lol

 

[shiv]

Some people also feel so hungry after a hypo that they overtreat without really realising, as you're not always that rational or able to resist temptation!

i'm the sort that when i hit a certain type of low, i raid the cupboards and eat until i feel better. literally. i will sit there munching on toast/sweets/oj/etc until i feel better. i have absolutely no rationality when i'm low, at all.

 

[Twitchy]

When I did the DAFNE course (quite a few years ago now, so this may be out of date!) they said that the carbs you take depend on how long until your next meal is... less than 1 hr til next meal, 1 1/2 - 2 carb portions (CPs) "quick acting" (QA) stuff (eg orange juice). If it's 1-2 hrs til next meal; 1 1/2 - 2 CPs QA stuff & 1 CP long acting (eg a couple of rich teas)... if its more than 2 hours til next meal, 2 QA CPs & 2 LA CPs. Knowing this, however, & being able to apply it in the middle of a hypo-hamster fit is another thing!! 🙄

I was also reminded today at hospital that when you go hypo you can run in double figures for up to 24 hrs after, due to the liver's release of glyco-thingy ... so not only do you have to not run high, you have to avoid hypos because they will make you run high too! Argh!! Fun.

 

[aymes]

Surely the maths says that if you need x grammes of carbs to raise your BG by 1 mmol then if you have enough to bring your BG up from 2.5 to say 6 then enough carbs to cover 3.5 mmol then no problem...? But however it doesn't seem to work.

That certainly works in theory but sadly when hypo the rules (not that diabetes really has hard and fast rules!) pretty much go out the window! Bit of an example today. I know that during the day 10g of carbs will raise my bg by about 3. About midday I had a reading of 3.3, now this was just before lunch so I treated the hypo with 25g QA carbs, and reduced my lunchtime dose (taken 30min after eating) but 1 unit. Now, using my usual experiences that should have raised me to something in the region of 12+, yet in reality I was hypo again by 2pm! Most people tend to have a standard treatment for a hypo, usually around 20g of quick acting carbs followed up by similar of slow acting dependant on what the level was, when the next meal is etc.

Hypos are also complicated by the body dumping out glucose as a reaction to the low (sadly not done when it would be useful) meaning you can get a rebound high. At some point also it may claw that glucose back, meaning that you may go low again! And of course the hypo 'munchies' don't help matters! Although you know in theory how many carbs you need to have to treat the hypo, when you're mid hypo waiting to see if you're ok in ten minutes isn't easy!

 

[sofaraway]

You can work out that x amount of carbs raises my blood sugar x points. But when treating a hypo, when you feel terrible and like you are going to pass out 15 minutes is a long time to wait to re-test, my brain starts panicing that as I still don't feel any better then I must be dropping lower and lower. So it's very hard not to eat until you feel better.

 

[Northerner]

I was interested to read in Ragnar Hanas' book today that symptoms in hypoglycaemia start at 2.9 mmol/l in non-diabetics, 3.7 if your HbA1c is 9% and 2.2 if your HbA1c is 5.2% - although you may get an adrenaline response at a higher level.

Probably explains why generally I feel OK intil I drop really low - my HbA1c is 5.2%! Also very interseting to see that a non-diabetic person will get symptoms earlier than me, despite their own levels being more or less perfectly controlled for most of the time!

 

[HelenM]

I was interested to read in Ragnar Hanas' book today that symptoms in hypoglycaemia start at 2.9 mmol/l in non-diabetics, 3.7 if your HbA1c is 9% and 2.2 if your HbA1c is 5.2% - although you may get an adrenaline response at a higher level.

Probably explains why generally I feel OK intil I drop really low - my HbA1c is 5.2%! Also very interseting to see that a non-diabetic person will get symptoms earlier than me, despite their own levels being more or less perfectly controlled for most of the time!

Now that is interesting, I'm not going towards hypo unawareness, I'm normal!
Incidently, I don't think I've ever had a rebound high either, I treat with the minimum carbs, usually 4-8gms and that gets me back quickly into the 5mmol range.

 

[runner]

I'm Type 2 and can't get my head around hypos that T1s have so here's a stoopid (for me) question or two.

Why does the blood sugars go sky high after a hypo correction?

Say you go hypo with a reading of say 2.5. You want to aim for a BG of say 6.

Surely the maths says that if you need x grammes of carbs to raise your BG by 1 mmol then if you have enough to bring your BG up from 2.5 to say 6 then enough carbs to cover 3.5 mmol then no problem...? But however it doesn't seem to work.

Is the liver interfering with corrections?

If you went hypo would you prefer to correct in small amounts sipping Lucozade or 'go for it' with a couple of Mars bars..?

Hi Tez, I think like some of the others have said - it can be sheer panic - it's just happening to me - see my post 'scary'